Generic Approved Cover Sheet

Attachment 1 - Example of approved NLM Survey.doc

Request for Generic Clearance to Conduct Voluntary Customer/Partner Surveys(NLM)

Generic Approved Cover Sheet

OMB: 0925-0476

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SUBMISSION OF INFORMATION COLLECTION

UNDER GENERIC CLEARANCES



DATE OF REQUEST: 10/1/2012


SUB AGENCY (I/C): National Library of Medicine


TITLE: WHR Consumer Focus Group (NLM/SIS)


GENERIC CLEARANCE UNDER OMB# ­ 0925-0476 EXP. DATE: 07/31/2015


ABSTRACT:

The Women’s Health Resources Web Portal (WHR) http://whr.nlm.nih.gov is conducting a series of focus groups with various target audience to better understand and serve their information needs in regards to women’s health and sex differences research. For this focus group our desired participants are congressional staffers who work for committees or members with a strong interest in health-related topics, legislation, or research. Participants will represent a mix of gender and political party affiliation.














TOTAL ANNUAL BURDEN APPROVED: 3,250


BURDEN USED TO DATE: 10 hrs.


BURDEN THIS REQUEST: 36


IS RACE AND ETHNICITY DATA COLLECTED AS REQUIRED?

______YES ___X_NO______N/A


OBLIGATION TO RESPOND:


X VOLUNTARY


______ REQUIRED TO OBTAIN OR RETAIN BENEFITS


______ MANDATORY


HOW WILL THIS SURVEY BE OFFERED?


_____ WEB SITE


_____ TELEPHONE INTERVIEW


_____ MAIL RESPONSE


__X IN PERSON INTERVIEW


_____ OTHER: ___________________________________


CONTACT INFORMATION:


NAME: Laura Bartlett_______________


TELEPHONE NUMBER: 301-496-3147


EMAIL ADDRESS: [email protected]

File Typeapplication/msword
File TitleINFORMATION COLLECTION REQUEST FOR GENERIC CLEARANCES
Authorcurriem
Last Modified BySharlip, David (NIH/NLM) [E]
File Modified2015-06-15
File Created2012-10-05

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